Effect of Umbilical Cord Milking vs Delayed Cord Clamping on Venous Hematocrit at 48 Hours in Late Preterm and Term Neonates: A Randomized Controlled Trial.

Abstract

OBJECTIVE:

To compare the effect of intact umbilical cord milking (MUC) and delayed cord clamping (DCC) on venous hematocrit at 48 (±6) hours in late preterm and term neonates (350/7- 426/7 wk).

STUDY DESIGN:

Randomized trial.

SETTING AND PARTICIPANTS:

All late preterm and term neonates (350/7 - 426/7 wk) neonates born in the labor room and maternity operation theatre of tertiary care unit were included.

INTERVENTION:

We randomly allocated enrolled neonates to MUC group (cord milked four times towards the baby while being attached to the placenta; n=72) or DCC group (cord clamped after 60 seconds; n=72).

OUTCOME:

Primary outcome was venous hematocrit at 48 (±6) hours of life. Additional outcomes were venous hematocrit at 48 (±6) hours in newborns delivered through lower segment caesarean section (LSCS), incidence of polycythemia requiring partial exchange transfusion, incidence of hyperbilirubinemia requiring phototherapy, and venous hematocrit and serum ferritin levels at 6 (±1) weeks of age.

RESULTS:

The mean (SD) hematocrit at 48 (±6) hours in the MUC group was higher than in DCC group [57.7 (4.3) vs. 55.9 (4.4); P=0.002]. Venous hematocrit at 6 (±1) weeks was higher in MUC than in DCC group [mean (SD), 37.7 (4.3) vs. 36 (3.4); mean difference 1.75 (95% CI 0.53 to 2.9); P=0.005]. Other parameters were similar in the two groups.

CONCLUSION:

MUC leads to a higher venous hematocrit at 48 (±6) hours in late preterm and term neonates when compared with DCC.

• Authors: Mukul Kumar Mangla, Anu Thukral, M Jeeva Sankar, Ramesh Agarwal, Ashok K Deorari, V K Paul
• Journal: Indian pediatrics (Indian Pediatr) Vol. 57 Issue 12 Pg. 1119-1123 (Dec 15 2020) ISSN: 0974-7559 [Electronic] India
• PMID: 33034301 (Publication Type: Journal Article, Randomized Controlled Trial)

Topics

• Cesarean Section
• Constriction
• Delivery, Obstetric
• Female
• Hematocrit
• Humans
• Infant, Newborn
• Infant, Premature
• Pregnancy
• Umbilical Cord